ANATOMY AND PHYSIOLOGY
Where does the liver receive blood from?
The hepatic artery and the portal vein
Elevated extracellular fluid concentrations of bilirubin lead to?
Jaundice, aka Icterus
What type of Hepatitis caused the most damage to the Liver?
Hepatitis B and C
What nutritional assessments can we use for patients with acute hepatitis?
Weight history-Diet history-Lifestyle factors
What patients are at higher risk of post-op complications and higher mortality rates?
Undernourished patients with cirrhosis
How much blood in the body can the liver store?
200-400 ml of blood
Lower serum proteins and lower oncotic pressure can cause?
Shift of fluid from the blood into the “third spaces” leads to Edema
Alcoholic Liver Disease (ALD) comprises a spectrum of three disorders.
Fatty liver (hepatic steatosis), Alcoholic hepatitis, and Cirrhosis.
What is the most common test for liver function?
Bilirubin, aminotransferases, alkaline phosphatase, and prothrombin time.
After recovery, patients are more susceptible to?
Food-borne infections as a result of the immune suppressing medications.
Inadequate glycogen storage in the liver can cause?
Hypoglycemia
What is the color of feces in obstructive jaundice?
Pale due to lack of Bile pigment.
What micronutrient deficiencies are common with Cirrhosis, especially if alcohol related?
Vitamin D, Folic Acid, B vitamins, and thiamin.
What is alpha antitrypsin deficiency associated with?
A genetic factor for increased iron level in the blood and lead to specific Liver disease.
What are some of the common side effects of Glucocorticoids?
Hyperglycemia, hyperlipidemia, sodium retention, nausea, and vomiting.
What is the emulsifying agent in the liver?
Bile Salt
The surgical procedure for ascites that reroutes blood flow to the liver and reduces pressure in all auxiliary veins?
The transjugular intrahepatic portosystemic shunt (TIPS)
Why do Cirrhosis patients need an increase in energy need?
Increase in energy expenditure because of vasodilation and expanded blood volume.
The liver protein biochemical labs used to determine visceral protein become abnormal due to?
Inflammation
Why is trophic feeding crucial during Immediate Post-transplantation?
Help keep the microvilli working.
Why do patients with Liver disease suffer from micronutrient deficiency?
The Liver is the primary site for vitamin and mineral storage.
What leads to depletion of glutamate and accumulation of glutamine in the brain?
Liver unable to detoxify ammonia.
Why is enteral feeding needed during the period of encephalopathy?
Help prevent further malnutrition
Which lab finding can be used to distinguish ALD from other liver diseases?
Ratio of AST/ ALT (Serum aspartate aminotransferase/Alanine aminotransferase)
At what stage does a liver transplant patient benefit from enteral nutrition?
Pre-transplantation